Q) A young 18 years old unrestrained car driver has an head on collision with a truck and becomes unconscious. He is intubated on the site of accident and resuscitated with IV fluids. He is brought to the emergency in a state of shock,( BP 90/60 and pulse 120/min) but opens eyes on commands. On examination he does not have pallor but neck veins are distended.
There are no signs suggestive of head or spine injury. Xray chest reveals normal cardiac chambers, no free gas and mild pleural effusion on left with no evidence of fracture ribs.
What will be the next step of management
a) Resuscitation and simultaneous CT thorax
b) Resuscitation and simultaneous Echo cardiography
c) Exploratory laparotomy
d) Chest tube drainage left side